The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials
IntroductionMyocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericardi...
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| مؤلفون آخرون: | , , , , , , , , , |
| التنسيق: | article |
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2024
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| الوصول للمادة أونلاين: | http://dx.doi.org/10.1016/j.cpcardiol.2024.102878 https://www.sciencedirect.com/science/article/pii/S0146280624005139 http://hdl.handle.net/10576/65515 |
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| _version_ | 1857415083708121088 |
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| author | Ayesha, Younas |
| author2 | Awan, Zainab Khan, Tehreem Mehta, Samay Munir, Aqsa Raja, Hafsa Arshad Azam Jain, Hritvik Raza, Ahmed Sehar, Ayesha Ahmed, Raheel Nashwan, Abdulqadir J. |
| author2_role | author author author author author author author author author author |
| author_facet | Ayesha, Younas Awan, Zainab Khan, Tehreem Mehta, Samay Munir, Aqsa Raja, Hafsa Arshad Azam Jain, Hritvik Raza, Ahmed Sehar, Ayesha Ahmed, Raheel Nashwan, Abdulqadir J. |
| author_role | author |
| dc.creator.none.fl_str_mv | Ayesha, Younas Awan, Zainab Khan, Tehreem Mehta, Samay Munir, Aqsa Raja, Hafsa Arshad Azam Jain, Hritvik Raza, Ahmed Sehar, Ayesha Ahmed, Raheel Nashwan, Abdulqadir J. |
| dc.date.none.fl_str_mv | 2024-10-10 2025-06-12T17:27:04Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://dx.doi.org/10.1016/j.cpcardiol.2024.102878 Younas, A., Awan, Z., Khan, T., Mehta, S., Munir, A., Raja, H. A. A., ... & Nashwan, A. J. (2024). The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials. Current Problems in Cardiology, 102878. 0146-2806 https://www.sciencedirect.com/science/article/pii/S0146280624005139 http://hdl.handle.net/10576/65515 1 50 1535-6280 |
| dc.language.none.fl_str_mv | en |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.none.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Colchicine Inflammation MI Myocardial infarction Cardiovascular death Anti-inflammatories Outcomes CRP |
| dc.title.none.fl_str_mv | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | IntroductionMyocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI. MethodsA Comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI from inception till May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, incidence of cardiac arrest, hospitalization urgency, incidence of recurrent MI, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and mean differences (MD) were pooled under the random-effects model. ResultsEleven trials with 7161 patients were included in our analysis out of which 3546 (49.51 %) were allocated to colchicine and 3591 (50.14 %) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR = 0.75, 95 % CI: 0.60-0.94, P = 0.01, I2 = 47 %), and hospitalization urgency (RR = 0.46, 95 % CI: 0.31-0.68, P = 0.0001, I2 = 0 %) but statistically significant increment in adverse gastrointestinal events (RR = 1.86, 95 % CI: 1.14-3.02, P = 0.01, I2 = 79 %). However, all-cause mortality (RR = 1.00, 95 % CI: 0.72-1.39, P = 0.98, I2 = 0 %), incidence of cardiac arrest (RR = 0.81, 95 % CI: 0.33-1.95, P = 0.63, I2 = 0), incidence of stroke (RR = 0.45, 95 % CI: 0.17-1.19, P = 0.11, I2 = 36 %), incidence of recurrent MI (RR = 0.78, 95 % CI: 0.57-1.06, P = 0.11, I2 = 11 %) and the levels of hs-CRP (MD= -0.87, 95 %CI: -1.80-0.06, P=0.07, I2=67 % remained comparable across the two groups. ConclusionThe use of colchicine post-MI reduces the composite of adverse cardiovascular events, and hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence, incidence of recurrent MI and the levels of hs-CRP. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | qu_6957f84faed2ac206f7b2491d0abaf39 |
| identifier_str_mv | Younas, A., Awan, Z., Khan, T., Mehta, S., Munir, A., Raja, H. A. A., ... & Nashwan, A. J. (2024). The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials. Current Problems in Cardiology, 102878. 0146-2806 1 50 1535-6280 |
| language_invalid_str_mv | en |
| network_acronym_str | qu |
| network_name_str | Qatar University repository |
| oai_identifier_str | oai:qspace.qu.edu.qa:10576/65515 |
| publishDate | 2024 |
| publisher.none.fl_str_mv | Elsevier |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| spelling | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trialsAyesha, YounasAwan, ZainabKhan, TehreemMehta, SamayMunir, AqsaRaja, Hafsa Arshad AzamJain, HritvikRaza, AhmedSehar, AyeshaAhmed, RaheelNashwan, Abdulqadir J.ColchicineInflammationMIMyocardial infarctionCardiovascular deathAnti-inflammatoriesOutcomesCRPIntroductionMyocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI. MethodsA Comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI from inception till May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, incidence of cardiac arrest, hospitalization urgency, incidence of recurrent MI, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and mean differences (MD) were pooled under the random-effects model. ResultsEleven trials with 7161 patients were included in our analysis out of which 3546 (49.51 %) were allocated to colchicine and 3591 (50.14 %) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR = 0.75, 95 % CI: 0.60-0.94, P = 0.01, I2 = 47 %), and hospitalization urgency (RR = 0.46, 95 % CI: 0.31-0.68, P = 0.0001, I2 = 0 %) but statistically significant increment in adverse gastrointestinal events (RR = 1.86, 95 % CI: 1.14-3.02, P = 0.01, I2 = 79 %). However, all-cause mortality (RR = 1.00, 95 % CI: 0.72-1.39, P = 0.98, I2 = 0 %), incidence of cardiac arrest (RR = 0.81, 95 % CI: 0.33-1.95, P = 0.63, I2 = 0), incidence of stroke (RR = 0.45, 95 % CI: 0.17-1.19, P = 0.11, I2 = 36 %), incidence of recurrent MI (RR = 0.78, 95 % CI: 0.57-1.06, P = 0.11, I2 = 11 %) and the levels of hs-CRP (MD= -0.87, 95 %CI: -1.80-0.06, P=0.07, I2=67 % remained comparable across the two groups. ConclusionThe use of colchicine post-MI reduces the composite of adverse cardiovascular events, and hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence, incidence of recurrent MI and the levels of hs-CRP. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings.The publication of this work was funded by Qatar National Library.Elsevier2025-06-12T17:27:04Z2024-10-10Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/j.cpcardiol.2024.102878Younas, A., Awan, Z., Khan, T., Mehta, S., Munir, A., Raja, H. A. A., ... & Nashwan, A. J. (2024). The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials. Current Problems in Cardiology, 102878.0146-2806https://www.sciencedirect.com/science/article/pii/S0146280624005139http://hdl.handle.net/10576/655151501535-6280enhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/655152025-06-12T19:06:17Z |
| spellingShingle | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials Ayesha, Younas Colchicine Inflammation MI Myocardial infarction Cardiovascular death Anti-inflammatories Outcomes CRP |
| status_str | publishedVersion |
| title | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials |
| title_full | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials |
| title_short | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials |
| title_sort | The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials |
| topic | Colchicine Inflammation MI Myocardial infarction Cardiovascular death Anti-inflammatories Outcomes CRP |
| url | http://dx.doi.org/10.1016/j.cpcardiol.2024.102878 https://www.sciencedirect.com/science/article/pii/S0146280624005139 http://hdl.handle.net/10576/65515 |